Crohn’s: The Remission and Relapse Cycle

Crohn’s disease is a disorder that causes irritation and swelling in the lining of the digestive tract. It’s a chronic illness, so most people will experience symptoms on and off throughout their life.

Crohn’s Disease Treatment

There are two main types of treatment for Crohn’s disease: medications and surgery. 

Most Crohn’s disease medications are meant to help reduce inflammation in the gastrointestinal tract. Some medicines are used to treat flares, while others help keep Crohn’s in remission once symptoms have gone away.

Surgery is an option, but it’s usually saved for hard-to-treat disease. Surgery can be used to open a part of the intestine that has become blocked. Surgery also can be used to remove a damaged portion of the intestine.

Surgery doesn’t cure Crohn’s, but it can help to achieve remission. About 70 percent of people with Crohn’s will need surgery at some point in their lives.

Flare Triggers

It’s not always possible to know what causes a flare. Flares happen even while you’re taking your medications as prescribed.

You may experience the same types of digestive problems you had when you were first diagnosed with the disease or you may experience new symptoms.

 Source: Healthline.com

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Keep Your Bones Strong

Make sure you get enough calcium and vitamin D. Crohn’s disease makes bone loss and osteoporosis (thinning bones) more likely. Steroids used to treat Crohn’s can also erode your bones. Most experts say you need between 1,000 and 1,300 milligrams of calcium and between 600 and 800 international units of vitamin D. Ask your doctor how much is right for you.

Protect Your Eyes and Vision

Tell your doctor if you notice eye problems like blurred vision, redness, and dryness. This disease can affect many parts of the eye, including the cornea, tear ducts, and outer coating of the white of the eye. When you control Crohn’s flares, most eye complications improve. Your doctor may prescribe drops to help.

 

Ease Joint Pain

About 1 in 4 people with the disease gets arthritis, or inflamed joints. You may have pain in your elbows, wrists, knees, and ankles. This type of arthritis doesn’t cause lasting damage. The pain will usually go away when your Crohn’s symptoms do. Some people get pain and stiffness in their lower back, which can be more serious. Your doctor may prescribe medications and tell you to rest.

Gallstones

Crohn’s can harm your small intestine, which leads to gallstones. Up to a third of people with the disease get them. When your small intestine is damaged, your body can’t absorb bile salts that it creates to break down waste. The salts form gallstones. Symptoms include sudden pain in your upper right abdomen and nausea. Treatment ranges from medications to surgery.

Skin Problems

Watch for changes in your skin. A small number of people with Crohn’s get red bumps on their shins, ankles, and arms. Doctors call these erythema nodosum. Only a fewer will get blisters that turn into chronic deep ulcers, but it can happen.

Liver Damage

Do you feel unusually tired or have itching, yellowing of the skin (called jaundice), or pressure in your upper abdomen? Those could be signs that Crohn’s is affecting your liver. Bring your doctor up to speed. He’ll examine your blood tests, ultrasounds, and maybe even a biopsy to see if there’s a problem.

Back Pain

If you have pain and stiffness in your lower spine, let your doctor know. It’s rare, but you might have spondylitis, a form of arthritis linked to Crohn’s. Over time, it can cause the bones in your spine to permanently fuse together. This is called ankylosing spondylitis. It happens in up to 3% of people with Crohn’s. Early treatment can help you keep your flexibility. Stretching exercises and using moist heat on your back can help you feel better.

Depression

Like many serious long-term illnesses, Crohn’s disease can make you depressed and anxious. That, in turn, can worsen your physical symptoms and make it harder to get better. Talk therapy and medications can help you manage these feelings.

See Your Doctors Regularly

Regular checkups with your primary doctor and your gastroenterologist are key. Put all appointments on your calendar. Let your doctor know about about any changes in your health, and mention any medications or supplements you’re taking.

Source: webmd.com

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Andrea Wiessner discusses the homeopathic treatment of one of her patients

Crohn’s disease

Pauline
Referred to me by her GP in November 2003, Pauline had been diagnosed with Crohn’s disease in 2000 but her GP men­tioned in his letter that she probably had already suffered symptoms due to the disease in 1993.

Pauline was 39 when I met her first and she told me that she had severe backaches with shooting pains in her 20s. The slightest movement would aggra­vate her pain. As she had injured her back as a child, she always thought the pain was due to this.

Ten years ago, she developed an anal fissure with severe pains passing stools. This was eventually operated on in 2000, but three weeks after the opera­tion she again started to have severe pain when passing stools and had ulcers in the back passage. She also had mouth ulcers at the time with extreme pain and she could hardly eat or drink. She started to feel unwell generally, had a high tem­perature, plus diarrhoea and stiff joints. Her ankles were swollen and she could hardly move or walk. Pauline had to stay off work for three months. At that stage she was referred to a specialist and diag­nosed with Crohn’s disease.

Since then she has had several flare-ups when she always has similar symp­toms. The first sign is usually that she develops back pain and stiffness. Her joints swell up and become stiff and painful, which makes it very difficult for her to move. She also develops loose and foul smelling bowel motions, lately with blood and mucus. She has abdominal cramps and a permanent sense of a lump in her stomach. She sometimes loses con­trol over her bladder and bowels and has had some accidents and feels extremely tired and exhausted and gen­erally unwell.

Pauline feels that these episodes can be triggered by stress and her symptoms can be aggravated by dairy produce. She frequently has night sweats and she also had episodes of iritis, inflammation of her eyes, in the past.

She has already excluded dairy produce which has been beneficial. Her consultant had put her on Mercaptopurin daily which is a medicine also used in the treatment of leukaemia and Dexameth­asone eye drops for episodes of iritis.

Pauline lives with her partner and eight year-old son and works in cus­tomer service for a company selling legal books. She loves her job and loves speak­ing to the customers on the phone. She feels this is “fantastic”.

Having a very bubbly personality, Pauline describes herself as over-enthu­siastic and excitable and quite a happy person who loves to talk a lot. She says people sometimes find her “too much”. She is very impatient and can be short-tempered. She dislikes to be told things and dislikes change. She is a kind per­son and feels anxious if she has to speak in public.

Of her general symptoms, she says that she is a chilly person, disliking the cold and that she perspires easily. She craves cheese and sweets and does not tolerate dairy produce. She needs a lot of sleep, often waking up at 2am but sleeps quite deeply on her right side. She talks during her sleep and her eyes are often half-open. She dreams a lot, recur­rently of houses and rooms but also about teeth.

Treatment
When considering her case, I was mainly thinking of remedies such as Phosphorus and Sepia, but Nux vomica, Causticum and Thuja were also ones I considered for her constitutionally. The last as her son, whom I treated for asthma, had a good response to Thuja and sometimes children and their parents, in particular mother and child, can respond to the same remedy.

Nevertheless, I eventually decided to give her Sepia. What swayed me was the strong focus on her back pain, which is very typical for Sepia, and symptoms such as the lump sensation in her stomach. I gave her Sepia 200c, three single doses within 24 hours. However, as Phosphorus is a good remedy for inflammatory bowel disease, I prescribed Phosphorus 30c twice weekly in four weeks’ time, more on a symptomatic level.

When I saw her again two months later, she was already much better. Her energy levels had improved, her joints weren’t aching and the night sweats were better too. She could sleep through the night and had been able to stop Mercap­topurin one month before without any negative effects. This had not been pos­sible in the past. She had noticed the improvement after the Sepia, but the night sweats improved when taking Phosphorus and did come back when she omitted a dose. Over the next six months she required two more doses of Sepia 200c and I advised her to continue with the Phosphorus regularly.

Recurrence
She then came back with a flare-up of her Crohn’s disease, experiencing burn­ing pain in her abdomen, pain and stiff­ness in her back and hips, iritis and low energy levels. When I asked what had happened, she told me that she had applied for a better paid job in her com­pany but that she didn’t get it. She was very angry, feeling it was terribly unfair and that people were conspiring against her. She just couldn’t understand why they hadn’t given her the job but did not talk to anyone about it.

I told her to increase Phosphorus to once daily doses until her symptoms had settled and to repeat Sepia in the next higher potency, 1M at that stage. How­ever, I told her to use her conventional medication if symptoms did not settle quickly. I also prescribed Mercurius sol 6c three times per day, when required, for her iritis.

When I saw her next, two months later, she had much improved. The pain had settled, her joints and back were fine and her energy levels better. She had taken Mercaptopurin for ten days but stopped it again and had been well.

Over the following two years, she had been really well apart from one chest and throat infection. She continued with Phosphorus 30c once weekly and Sepia 1M every few months.

A year ago she came to see me with severe back pain again, associated with stiffness and pain in her hip. She had been run down and felt this might be a precursor for the Crohn’s again. She had already tried Sepia, but this time it did not seem to affect her symptoms. I prescribed Rhus tox 30c once daily until the back pain had settled and told her to then take Phosphorus 200c, three sin­gle doses within 24 hours. She has been fine since with one more minor episode of back pain, which responded well again to Rhus tox. She now takes Phosphorus 200c every few months if her general well-being deteriorates.

The remedies
The remedies that helped Pauline most were Sepia, the ink of the cuttle fish, and Phosphorus, a remedy from the mineral kingdom and an element from the peri­odic table. On first glance, this seems strange as they come from completely different sources. However, patients who require Sepia sometimes appear quite “phosphoric” and this might be due to the fact that the cuttle fish itself contains a lot of Phosphorus.

In retrospect, I would say that Pauline is probably more of a Phosphorus type constitutionally. However, she had good responses to Sepia initially, possibly due to the overlapping symptoms of both remedies. The question why she respond­ed and which one is her constitutional remedy is probably quite academic though, as the main thing is that Pauline’s symptoms improved and that she is on her path to health.

Phosphorus
Phosphorus means the “light-bringer” (the Greek word “phos” means light and “phoros” means bringing or bearing). Phosphorus is a poisonous substance and reacts violently. It is used in the man­ufacture of safety matches. On a phys­ical level, Phosphorus’s destructive processes dominate the homeopathic picture, such as irritation and inflam­mation of the lining of organs, inflam­mation of nerves and the spinal cord and destruction of bones. Its picture also con­tains haemorrhages and general weak­ness. But just like the fire, destructive as it can be, it also brings warmth, light and sustains life.

As Phosphorus brings light in the physical sense, the Phosphorus type of person is a light-bringer in other ways. He or she is a very open and extrovert person who makes you feel good in their presence. Often, when they enter the room you have a sense that the light has been switched on. No wonder that during homeopathic training, when everyone is usually eager to find his or her own constitutional remedy, everyone wants to be a “Phosphorus”! These individuals are very warm, sociable and sympathetic and very sensitive to all impressions. They are often quite artistic and imag­inative but can also be full of fears and anxieties.

I always find it fascinating how the richness of nature, contained within our remedies, if matched to the richness of life within our patients, can stimulate growth, health and wellbeing!

Andrea Wiessner T(GP) MD MFHom RCST trained as a GP but has been practising homeopathy full-time for nine years. She has been working at the Royal London Homeopathic Hospital and in private practice. She also practises Cranio Sacral Therapy.

 Source: britishhomeopathic.org

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Top Foods to Avoid With Crohn’s Disease

For a person with Crohn’s disease, eating a healthy diet isn’t as simple as it may seem. If you’re experiencing chronic diarrhea, you may have nutritional deficiencies to overcome, and this is especially true for children with Crohn’s disease that affects the small bowel. On top of this, certain foods — even foods that are considered nutritious, such as raw fruits and vegetables — can trigger a Crohn’s flare or worsen symptoms. “Foods differ for each person, and people often choose to avoid them,” says Ryan S. Carvalho, MD, attending physician in the division of gastroenterology and nutrition at Nationwide Children’s Hospital in Columbus, Ohio. “However, caution is necessary to prevent excessive calorie, protein, and nutrient deprivation.” It’s easy to see why eating a good diet with Crohn’s is so important.

Even children notice when certain foods trigger theirCrohn’s symptoms, says Dr. Carvalho. Because foods that may act as triggers vary so widely, he suggests using a food diary to establish your diet for Crohn’s disease. “Maintaining a diary will also help you calculate your average calorie, protein, nutrient, and vitamin intake with the help of a dietitian,” Carvalho says. The following foods are considered common triggers for a Crohn’s flare — be particularly aware of your reaction when you eat them and jot down all the details in your food diary.

Beware the Dangers of Dairy

If you have Crohn’s disease, it’s not uncommon to also be lactose intolerant. That means you don’t adequately digest lactose, the sugar found in milk, and as a result you may have symptoms such as cramping, bloating, diarrhea, and gas, says Gina Jarman Hill, PhD, RD, an associate professor of nutrition at Texas Christian University in Fort Worth. “Dairy products are a good source of calcium, vitamin D, and protein, so if you completely avoid these foods, you must obtain these nutrients elsewhere,” she says. To minimize Crohn’s symptoms while staying healthy, try getting these nutrients from green leafy vegetables, fortified juices and cereals, or supplements. (everydayhealth.com)

Skip on the Spicy Foods

When your Crohn’s symptoms are in overdrive, spicy foods may result in even more pain for you, says Hill. “However, this is different from one person to the next,” she adds, “so it is important to identify those foods that are or are not tolerated.” If you find certain spices irritating during a Crohn’s flare, mild herbs and small amounts of citrus juices for seasoning can provide flavor in their place — it makes sense to always have them handy for jazzing up your diet.

Fried food isn’t good for anyone, and its greasiness may be especially problematic for people with Crohn’s, Dalessandro says. “The more you can stay away from foods like that, the better off you’ll be.” (everydayhealth.com)

Use Caution With Fried or Greasy Foods

For people with Crohn’s disease, the fat in foods like fried chicken, french fries, heavy sauces, and creams is often not fully absorbed in the small intestine. This in turn leads to Crohn’s symptoms like cramping or loose stools. Rather than fried and greasy foods, choose foods that are baked, broiled, or steamed for your diet for Crohn’s, says Hill. “However, fat should only be restricted if you’re experiencing fatty stools.” (everydayhealth.com)

Steer Clear of High-Fiber Foods

Though most people should be getting plenty of fiber from sources such as whole grains, fruits, and vegetables, the opposite is true for many individuals with Crohn’s disease. When Crohn’s symptoms are at their worst, make refined breads and pastas part of your modified diet. “They are normally better tolerated than their higher-fiber counterparts,” Hill explains. (everydayhealth.com)

Look Out for Foods With Gluten

Hill notes that refined wheat products are usually a better choice than whole grain options for people with active Crohn’s flares, but this alternative won’t help if you can’t digest the gluten found in wheat products. “Some people with Crohn’s disease may be gluten intolerant,” she says. If that’s the case, avoid all products that contain gluten in your diet. (everydayhealth.com)

Nuts

Nuts are nutritious, but when eaten raw, most people with Crohn’s won’t reap the benefits of their healthy fats and high protein content.

“You can’t masticate them enough to get them to a consistency that’s really easy for the gut to digest,” explains Dalessandro, who is a nutritional advisor to the Crohn’s & Colitis Foundation of America.

Like other rough and hard-to-digest foods, she adds, they can further irritate the lining of your gut, worsening your symptoms. (health.com)

 Fruit with skin

An apple a day may keep the doctor away, but if it isn’t peeled, it can cause major digestive distress for someone with Crohn’s.

The same goes for vegetables with edible peels, like cucumbers. Strip them off before you eat them. In fact, some people with Crohn’s find they can eat raw fruit and even some raw vegetables if they’ve been peeled.

In general, cooked or canned fruits and vegetables are often a better choice than raw. (health.com)

Popcorn

Whole grains are good for everyone—except a person with Crohn’s disease who’s having a flare-up.

Popcorn is technically a whole grain, and it’s probably among the hardest of all those grains to digest. The same goes for corn on the cob.

“Anything that’s really rough to digest would possibly be detrimental and cause more symptoms and possibly slow the healing process,” says Dalessandro. “That’s been my experience with a lot of patients, and myself.” (health.com)

Cured meat

It’s extremely important for people with Crohn’s disease to get enough protein; at least 25% of your daily calorie intake should be protein-based.

But eating fatty and cured meats, like bacon, is not the best way to add protein to your diet.

These foods offer little nutritional benefit, while their high fat content can aggravate diarrhea for some people. Instead, choose lean high-quality proteins, like fish, soy, and smooth nut butters. (health.com)

Seeds

During a flare, people with Crohn’s should avoid foods that contain lots of seeds, such as strawberries, raspberries, and tomatoes, Dalessandro advises.

“Those things don’t get digested fully and can cause more diarrhea,” she explains. “You want to stay away from things that are rough on the digestive system…it’s kind of like sandpaper on an open wound.”

Also, skip rye bread and other baked goods that contain seeds. (health.com)

Tomatoes

Maybe it’s the skin, maybe it’s the seeds, or maybe it’s the acidity, but many people with Crohn’s find that eating tomatoes in any form worsens their symptoms, whether it’s a raw tomato in a salad or spaghetti sauce. (health.com)

Coffee, chocolate, and carbonated beverages

Many coffee lovers have to swear off java after getting a diagnosis of Crohn’s.

“Anything with caffeine is really bad, chocolate is really bad,” says Julie Novack, 44, a senior credit underwriter at Wells Fargo in Charlotte, North Carolina, who has ulcerative colitis.

Novack and other people with IBD can also have trouble with caffeinated sodas, while bubbly drinks—caffeinated or no—can be triggers as well.

Alcohol

Use caution when drinking alcohol, as it can be a problem for some people with inflammatory bowel disease.

“If I drink too much of it or too often it will sometimes cause a flare or seems to cause a small flare,” says Marge McDonald, 46, who directs the Burlington Senior Center in Massachusetts and has ulcerative colitis. (health.com)

Avoid roughage

Corn, beans, and stringy vegetables like raw celery and broccoli aren’t easily digested; in Crohn’s they can cause cramping, bloating, and diarrhea.

“We call it roughage, and it’s rough on your system,” says Dr. Kane. “For a healthy intestine, that is a good thing, but for an inflamed one, it can be bad. Having to process things that are still intact will make some people really uncomfortable.”

Dr. Kane suggests trying a “low-residue diet” that is low in fiber and other foods that are difficult to digest like raw fruit, vegetable peels, and seeds. “When you have active IBD symptoms, these foods are just going to make you feel lousy,” she says. (health.com)

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 Healthy-Eating Tips for Crohn’s Disease

Specific foods don’t cause or trigger Crohn’s disease. However, some foods or eating habits can exacerbate symptoms. Each person is different, so you may need to use trial and error to see what helps (or hurts) your symptoms.

What, and how, to eat

by Amanda MacMillan

Crohn’s disease is a chronic, incurable inflammatory bowel disease (IBD). Symptoms include severe belly pain and diarrhea, among others.

Certain foods or eating habits can exacerbate Crohn’s disease symptoms, although they aren’t the underlying cause or trigger of the IBD, says Sunanda Kane, MD, professor of gastroenterology at the Mayo Clinic, in Rochester, Minn.

Each person is different, so you may need to use trial and error to see what types of food or eating habits help (or hurt) your symptoms.

Foods That May Help Ease Crohn’s Symptoms

Yogurt

• Oily Fish

  

  Oily fish such as salmon, tuna, and herring may help with some of your Crohn’s symptoms (Cleveland Clinic, 2009). Certain types of both contain omega-3 fatty acids, which have anti-inflammatory properties and may help reduce the inflammation that causes the worst of your symptoms (Simopoulos, 2002).

  Fruits & Vegetables

  

  A diet containing plenty of fruits and vegetables can help make symptoms less severe (UMMC, 2010). If, however, you find that raw fruits exacerbate a flare-up, give unsweetened applesauce and bananas a try. Both are good for you and can fulfill your craving for healthy sweetness.

Cooked Carrots

Cereals

Liquid Meals

Low-Fiber Foods and More

Potatoes

 Source: healthline.com

Don’t skimp on protein

People with Crohn’s disease often give up meat, beans, and cheese. But without protein, you can lose muscle mass.

“People say to me, ‘I gave up red meat because I can’t digest it,’ but it’s because they’re trying to eat a normal American-size helping of steak or a giant burger,” says Dr. Kane. “I tell them to eat 6 ounces of really good quality red meat; that way they’ll get the iron and protein they need without overdoing it.” Fish, tofu, beans, and eggs, if they’re well tolerated, are also good protein sources. (health.com)

 

Consider a liquid diet

Although it’s not a long-term solution, people with Crohn’s—especially those with intestinal blockages who are unable to process solid foods—can try a temporary liquid diet.

A liquid diet can give the intestines a rest, which can help suppress symptoms. However, this diet should be carefully planned with your doctor to ensure you’re getting all the right nutrients.

High-calorie liquid supplements, such as Ensure Plus or Boost Plus, can add nutrients and calories to any diet, as well, if you’re not getting enough from food alone. (health.com)

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Talk to a nutritionist

If you have Crohn’s disease and are concerned about your nutrition, it would be a good idea to talk with an RD, especially one who is familiar with IBD, says Julie Cepo, a registered dietitian who works with IBD patients at Mount Sinai Hospital, in Toronto, and is coauthor of the Crohn’s & Colitis Diet Guide(amazon.com).

“I help them come up with an eating strategy that they can tolerate but that also works with their personal and cultural preferences and food philosophies,” Cepo says.

Seeing a nutritionist who doesn’t understand IBD, on the other hand, may do more harm than good, warns Dr. Kane.

 Write it down

Keep track of everything you eat, how you feel after you eat it, and the status of your disease to determine what types of food worsen your IBD symptoms. Because it’s different for every person, writing everything down is the best way to learn what your body can and can’t process.

“Also, I ask people not to introduce a lot of new foods too quickly,” says Cepo. “Introduce them one at a time and wait a day or two to see if affects your symptoms.”

It’s not a bad idea to try new foods at home first, before eating them in a social situation.

Eat small, frequent meals

Portion control is important, because eating too much at one time can make it hard for the body to digest food.

Small, frequent meals can help. You can still eat three meals a day, but make them a bit smaller than usual, and supplement them with several well-balanced snacks in between.

“You won’t go into your next meal as hungry, and you’ll be less likely to overeat, which may lead to bloating,” says Cepo.

Prep foods in a new way

Many foods that are a problem when raw or whole can be eaten if prepared differently, says Cepo. “We try to focus on what people can still have; often that means cooking foods well, like string beans, cauliflower, or carrots and sweet potatoes.”

Stringy foods like onions may be better tolerated if minced into very small pieces, just as seeds and nuts seem to cause fewer symptoms when they’re ground. Chickpeas and sesame seeds, for example, may cause problems, but hummus, which is made with ground chickpeas, and tahini, a sesame-seed paste, may not.

Stay hydrated

Water intake is always important, but critically so if you have frequent diarrhea.

Cepo cautions patients to limit beverages with caffeine, carbonation, or too much sugar—all things that can make GI symptoms worse.

Water is a good choice, she says, as are diluted fruit juices without a high sugar content. For people who are very sick and at risk of becoming dehydrated, an over-the-counter rehydration fluid like Gatorade can replenish fluids and electrolytes.

Pump up your electrolytes

Replenish lost electrolytes like sodium and potassium if you’re having loose stools. “One option is to sprinkle salt liberally on your food,” says Cepo. You can also sip broths or bouillons, and choose salty snacks like pretzels, crackers, rice cakes, or potato chips.

To get more potassium, eat potatoes (without skin), bananas, tomato juice or sauce, avocados, melon, or citrus fruits like grapefruit or orange (with the membrane removed, if needed). Coconut water is also a good source of potassium, and a good way to stay hydrated.

 

Season with ground spices

Spicy food can be a problem, but that’s no reason to ban all herbs and spices from your kitchen. “I see spice as an important part of any diet, especially since one of the side effects of IBD is having a depressed appetite,” says Cepo. “Anything we can do to stimulate people’s interest in food is a good thing.”

Cepo recommends using flaked or chopped spices and herbs. “If you find you have any symptoms, hold back a little more the next time you use it.”

Supplement with vitamins

All people with IBD should take a multivitamin, says Dr. Kane, because they’re probably not getting all the nutrients they need.

People who avoid dairy should also consider taking about 1,500 milligrams of calcium with 800 IU of vitamin D daily. Those who have had small-intestine surgery probably need extra vitamin B12, too.

Talk to your doctor before taking any supplement, and remember, supplements should do just that: supplement the nutrients you get from foods, rather than replace them.

Eat normally when you’re well

In between Crohn’s flare-ups, if you’re feeling better, eat normally and enjoy your food.

“It can be hard for someone, knowing that the last time they ate celery they had a terrible experience, but it may be tolerated again when the disease is in remission,” Cepo says. “Working with a dietitian or a doctor can help you build back up confidence and improve that relationship with food.”

As long as you don’t have any ongoing bowel issues or long-term narrowing of your intestine, following general healthy-eating guidelines is a good strategy, says Cepo.

 Source: health.com

Crohn’s is a chronic disease so there’s no cure. However, there are medications available to help manage the symptoms and prevent relapse.

NOTE:

Healthline content is strictly informational and should not be considered medical advice. See a certified medical professional for diagnosis and treatment recommendations.